Acne vulgaris is the most common skin disease, causing temporary and permanent disfigurement. Acne typically appears on the face, back and/or chest at the onset of adrenarchy, i.e. when sex hormone activity increases in both boys and girls near puberty. Women often experience cycle-dependent acne. Acne is a disease of the sebaceous glands. Sebaceous glands are glands within the skin connected to a hair-containing canal called a follicle. The combination of the follicle and sebaceous gland is sometimes referred to as a “pilosebaceous unit.” In healthy skin, the sebaceous glands produce sebum which flows out of the skin through the follicle. In diseased skin, the follicle becomes plugged with dead skin cells.
Sebum, an oily product of the sebaceous gland and cellular debris build up in the plug. Inflammation and often rupture of the hair follicles ensues, leading to gross inflammation, pus (a “whitehead”), pain, bleeding, and/or eventual scarring. If the acne lesion consists of an accumulated unruptured plug within a hair follicle, a “blackhead” forms. If the follicle ruptures superficially, a small pustule forms that often heals after a few weeks without scarring. If the follicle ruptures within the mid or deep dermis, a painful cystic abscess forms. Cystic acne usually heals with permanent and disfiguring scars.
The exact pathophysiology of acne is complex; however, several basic elements are necessary to produce an acne lesion, and acne therapies are based on attacking one or more of these basic elements. First, an active sebaceous gland is necessary. Sebaceous gland activity is driven by androgen and other sex steroid hormones. Second, a plug must form in the outflow tract of the follicle, called the infundibulum.
Bacteria, particularly Proprionobacteria acnes (P acnes) that digest sebum and follicular debris, contribute to plugging. Besides P acnes, numerous other strains of bacteria and other microorganisms reside within a patient's skin and contribute to the plugging. Further, tiny microorganisms besides bacteria also are typically found to reside in a patient's skin and can exacerbate acne.
The most potent treatments for acne are oral retinoids such as retinoic acid (Accutane®), which inhibit sebaceous gland function. While effective, oral retinoids such as the Accutane® drug have serious side-effects that prevent certain patients from using them. Most notably, these drugs can cause serious birth defects which prevents women of child-bearing years from using these treatments.
Many topical treatments including creams, gels, and various cleansing pads have been used to treat acne. These treatments include both over-the-counter treatments and those available only by prescription such as the Retin A® drug that is applied as a cream to the patient's body. The major drawback of topical treatments is that the creams or other substances are used up and must be constantly replaced.
Other methods and systems use various devices to treat acne which eliminates the problems of topical treatments in that devices are not used up and do not need constant replacement. Some devices pass heat through acne diseased skin or heat the surface of the skin. One such device is the Zeno™ device produced by Tyrell, Inc. of Houston, Tex. Unfortunately, these devices are not very effective, are not comfortable to use, and they cannot treat severe acne. One reason that these devices are not very effective is that they apply heat to the surface of the skin only, requiring the heat to travel down to the sebaceous gland to have any effect. It would be desirable to provide a method and system for heating the sebaceous gland directly and the area surrounding the sebaceous gland without applying unneeded heat to the patient's skin away from the sebaceous gland.
Yet other methods and systems treat acne by delivering energy to the acne diseased skin at levels that are strong enough to damage or destroy the tissue. Other techniques affect tissue by causing coagulation of the tissue, which is also effective.
Unfortunately, ablative and coagulative acne treatment methods have their drawbacks. Specifically, because they utilize enough energy to destroy or coagulate tissue, ablation and coagulation devices and techniques are generally not available over the counter for the general public's use. Therefore, it would be advantageous to provide a treatment system that is suitable for home use that can effectively treat all forms of acne, including severe acne.
It would also be advantageous to have a system and method whose use can prevent acne and/or reduce the amount of sebum production before acne flares up, or to simply to reduce skin oiliness.